The impact of psychiatric labeling on course of illness is being investigated at two levels. Within the treatment system, we hypothesize that the more "intrapsychic" the dominant explanations of illness, the higher the level at which treatment discretion is located, and the more integrated and extensive the system, the more likely it is that patients will be maintained in a sick role. Interpersonally, we hypothesize that the relative power of and respective beliefs of the patient, his intimates and treatment agents will combine to sustain the sick role of the less powerful patient interacting with the more intrapsychically-oriented relatives, friends and treatment people. Two contrasting treatment systems are being examined and 30 first-admission patients from each system followed for the first year after discharge - the patient, a person close to him and a recent treatment agent being interviewed at four points during that year. The interviews include information on the social status and psychiatric beliefs of these respective parties, on negotiation processes among the parties, and on the social performance and psychiatric symptoms of the patients. This data is to be used in the construction of an empirical causal model showing how social experiences sustain or dispel the label of "illness" and the presence of clinical symptoms.